NCLEX NCLEX-RN Practice Exam - 865 Unique Questions
Latest Questions NCLEX-RN Guide to Prepare Free Practice Tests
NCLEX-RN is a standardized exam that is used to determine if a nurse is ready to begin practicing as a registered nurse (RN) in the United States. NCLEX-RN exam is developed and administered by the National Council of State Boards of Nursing (NCSBN) and is designed to assess a nurse's knowledge, skills, and abilities in relation to the safe and effective delivery of patient care.
NCLEX-RN exam consists of multiple-choice questions that assess a candidate's knowledge of nursing practice, client needs, and nursing process. The questions are designed to be comprehensive and may cover a wide range of topics, including pharmacology, anatomy and physiology, and nursing procedures. NCLEX-RN exam is computer-adaptive, meaning that the difficulty of the questions adapts to the candidate's level of knowledge.
NCLEX-RN exam is a vital step towards becoming a registered nurse. It is a standardized examination that tests the candidate's knowledge, skills, and abilities across a range of nursing practice areas. Passing the exam is essential for obtaining a nursing license and practicing as a registered nurse in the United States and Canada. Preparing for the exam is crucial, and candidates should take advantage of the available resources to ensure success.
NEW QUESTION # 499
The physician has ordered that a daily exercise program be instituted by a client with type I diabetes following his discharge from the hospital. Discharge instructions about exercise should include which of the following?
- A. Hyperglycemia may occur 2-4 hours after exercise.
- B. Exercise should be performed 30 minutes before meals.
- C. The blood glucose level should be 100 mg or below before exercise is begun.
- D. A snack may be needed before and/or during exercise.
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Exercise should not be performed before meals because the blood sugar is usually lower just prior to eating; therefore, there is an increased risk for hypoglycemia. (B) Exercise lowers blood sugar levels; therefore, a snack may be needed to maintain the appropriate glucose level. (C) Exercise lowers blood sugar levels. (D) Exercise lowers blood sugar levels. If the blood glucose level is 100 mg or below at the start of exercise, the potential for hypoglycemia is greater.
NEW QUESTION # 500
A pregnant client complains of varicosities in the third trimester. Which of the following activities should she be advised to avoid?
- A. Wearing support pantyhose
- B. Sitting with legs crossed at ankles
- C. Wearing knee-high stockings
- D. Wearing thromboembolic disease (TED) stockings
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Sitting with the legs crossed at the ankles does not interfere with circulation or create pressure points.
(B) TED stockings will help to reduce the varicosity by supporting the vein. Stockings must be applied with legs elevated. (C) Support pantyhose help to reduce the varicosity by supporting the vein. They also provide support to the uterus and allow for better return circulation. Hose must be applied like TED stockings. (D) Knee-high stockings create constriction and pressure points that interfere with circulation in the lower extremities.
NEW QUESTION # 501
A 70-year-old client has pneumonia and has just had a respiratory arrest. He has just been intubated with an 8- mm endotracheal tube. During auscultation of his chest, breath sounds were found to be absent on the left side. The nurse identifies the most likely cause of this as:
- A. Right mainstem bronchus intubation
- B. Left-sided pneumothorax
- C. Pneumonia
- D. Inappropriate endotracheal tube size
Answer: A
Explanation:
(A) Appropriate endotracheal tube sizes for adults range from 7.0-8.5 mm. (B) Pneumothorax could be indicated by an absence of breath sounds on the affected side. However, in a recently intubated client, the first priority would be to consider tube malposition. (C) During intubation, the right mainstem bronchus can be inadvertently entered if the endotracheal tube is inserted too far. Left mainstem bronchus intubation almost never occurs because of the angle of the left mainstem bronchus. (D) Breath sounds for someone with pneumonia may be decreased over the areas of consolidation. However, in a recently intubated client, the first priority would be to consider tube malposition.
NEW QUESTION # 502
A female client has a chest tube placed. It is accidentally pulled out of the intrapleural space when she is ambulating. The first action the nurse should take is to:
- A. Auscultate the lung to determine if she needs the tube replaced
- B. Apply a petrolatum dressing over the site
- C. Instruct the client to cough deeply to re-expand her lung
- D. Put on sterile gloves and replace the tube
Answer: B
Explanation:
(A) This action is inappropriate. Coughing will not re-expand the lung and could result in further harm. (B) This action is a medical procedure, not a nursing procedure. (C) An occlusive dressing will prevent further air leak until the physician institutes further treatment. (D) The decision to reinsert the tube is a medical decision, not a nursing one.
NEW QUESTION # 503
A 27-year-old primigravida stated that she got up from the chair to fix dinner and bright red blood was running down her legs. She denies any pain previously or currently. The client is very concerned about whether her baby will be all right. Her vital signs include P 120 bpm, respirations 26 breaths/min, BP
104/58 mm Hg, temperature 98.2_F, and fetal heart rate 146 bpm. Laboratory findings revealed hemoglobin 9.0 g/dL, hematocrit 26%, and coagulation studies within normal range. On admission, the peripad she wore was noted to be half saturated with bright red blood. A medical diagnosis of placenta previa is made. The priority nursing diagnosis for this client would be:
- A. Potential for fluid volume excess related to fluid resuscitation
- B. Decreased cardiac output related to excessive bleeding
- C. Alteration in parenting related to potential fetal injury
- D. Anxiety related to threat to self
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Based on the client's history, presence of bright red vaginal bleeding, and hemoglobin value on admission, the priority nursing diagnosis would be decreased cardiac output related to excessive bleeding.
(B) This nursing diagnosis is a potential problem that does not exist at the present time, and therefore is not the priority problem. (C) The client's expressed anxiety is for her child. The fetus will remain physiologically safe if the decreased cardiac output is resolved. (D) Initial spontaneous bleeding with placenta previa is rarely life threatening to the mother or the fetus. Delivery of the fetus will be postponed until fetal maturity is achieved and survival is likely.
NEW QUESTION # 504
A newborn infant is exhibiting signs of respiratory distress. Which of the following would the nurse recognize as the earliest clinical sign of respiratory distress?
- A. Cyanosis
- B. Decreased respirations
- C. Sternal and subcostal retractions
- D. Increased respirations
Answer: C
Explanation:
(A) Cyanosis is a late clinical sign of respiratory distress. (B) Rapid respirations are normal in a newborn. (C) The newborn has to exert an extra effort for ventilation, which is accomplished by using the accessory muscles of ventilation. The diaphragm and abdominal muscles are immature and weak in the newborn. (D) Decreased respirations are a late clinical sign. In the newborn, decreased respirations precede respiratory failure.
NEW QUESTION # 505
Which of the following procedures is necessary to establish a definitive diagnosis of breast cancer?
- A. Breast tissue biopsy
- B. Thermography
- C. Diaphanography
- D. Mammography
Answer: A
Explanation:
Explanation
(A) Diaphanography, also known as transillumination, is a painless, noninvasive imaging technique that involves shining a light source through the breast tissue to visualize the interior. It must be used in conjunction with a mammogram and physical examination. (B) Mammography is a useful tool for screening but is not considered a means of diagnosing breast cancers. (C) Thermography is a pictorial representation of heat patterns on the surface of the breast. Breast cancers appear as a "hot spot" owing to their higher metabolic rate.
(D) Biopsy either by needle aspiration or by surgical incision is the primary diagnostic technique for confirming the presence of cancer cells.
NEW QUESTION # 506
A client's prenatal screening indicated that she has no immunity to rubella. She is now 10 weeks pregnant. The best time to immunize her is:
- A. Within 72 hours postpartum
- B. After the first trimester
- C. In the immediate postpartum period
- D. At 28 weeks' gestation
Answer: C
Explanation:
(A) The rubella vaccine is made with attenuated virus and is given in the immediate postpartal period to prevent infection during pregnancy and subsequent adverse fetal and neonatal sequelae. Mothers are advised to prevent pregnancy for 3 months following immunization. (B) Rubella infection during the second trimester may result in permanent hearing loss for the fetus. (C) RhoGam is the drug generally administered at 28 weeks' gestation to Rh-negative women. It is contraindicated to administer rubella vaccine during pregnancy. (D) RhoGam is the drug administered within 72 hours postpartum to Rh-negative women to prevent the development of antibodies to fetal cells.
NEW QUESTION # 507
In evaluating the effectiveness of magnesium sulfate (MgSO4), which of the following might indicate that the client was developing MgSO4 toxicity?
- A. Respirations of 12 breaths/min
- B. Urine output of 40 mL/hr
- C. A 21 proteinuria value
- D. A 31 patellar tendon reflex
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Diminished (not accentuated) patellar tendon reflex is a sign of developing MgSO4 toxicity. A value of
21 is considered a normal tendon reflex; 3+ is considered brisker than normal. (B) MgSO4 is a central nervous system (CNS) depressant. It also relaxes smooth muscle. If the respiratory rate is <16 bpm magnesium toxicity may be developing. (C) Urine output of 40mL/hr is enough to allow elimination of toxic levels of magnesium. Urinary output of <100 mL in a 4-hour period may result in toxic levels of magnesium.
(D) Presence of protein in the urine is a symptom of pregnancy-induced hypertension (PIH), a clinical syndrome for which magnesium sulfate is frequently used in medical management. Protein in the urine is not induced by magnesium sulfate intake.
NEW QUESTION # 508
A male client has burns over 90% of his body after an automobile accident resulting in a fire. He was trapped inside the auto and pulled out by a bystander. After several months in the hospital and over 20 surgeries, discharge planning has begun. Throughout his hospitalization the nursing staff has been aware of psychological changes the client faces after burns over a large portion of his body resulting in disfigurement.
The nursing staff can best foster the client's self-esteem by:
- A. Adhering to a strict schedule of diet, exercise, and wound care
- B. Allowing him to plan, assist in, and perform his own care whenever possible
- C. Following a standardized plan of care for burn clients formulated by a world-renowned burn center
- D. Allowing him to go to physical therapy for whirlpool treatment when other clients were not in physical therapy
Answer: B
Explanation:
Explanation
(A) A regimented schedule, allowing no flexibility, will not foster the client's self-esteem. (B) Isolating the client may only enhance his feelings of social isolation due to his disfigurement. (C) Standardized care plans must be personalized and adapted to each client's situation. (D) Allowing the client control over his care will foster his self-esteem and prepare him for life outside of the hospital.
NEW QUESTION # 509
The nurse provides a male client with diet teaching so that he can help prevent constipation in the future.
Which food choices indicate that this teaching has been understood?
- A. Bagel with cream cheese
- B. Pancakes and syrup
- C. Omelette and hash browns
- D. Cooked oatmeal and grapefruit half
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) Eggs and hash browns do not provide much fiber and bulk, so they do not effectively prevent constipation. (B) Pancakes and syrup also have little fiber and bulk, so they do not effectively prevent constipation. (C) Bagel and cream cheese do not provide intestinal bulk. (D) A combination of oatmeal and fresh fruit will provide fiber and intestinal bulk.
NEW QUESTION # 510
A 25-year-old outpatient presents with a diagnosis of compulsive personality disorder. His coworkers become annoyed with his rigid, perfectionistic manner and preoccupation with trivial details and schedules. A nursing intervention appropriate for this client would include:
- A. Encouraging him to engage in recreational activities
- B. Avoiding discussion of his annoying behavior
- C. Encouraging the client to set a time schedule and deadlines for himself
- D. Contracting with him for the amount of time he will spend on the compulsive behaviors
Answer: D
Explanation:
Explanation
(A) This answer is incorrect. The client will work hard at the activity instead of enjoying it. (B) This answer is incorrect. The nurse should allow the client to discuss these thoughts, within limits, not to avoid discussing them. (C) This answer is incorrect. The compulsive client tends to control time to excess. It should not be encouraged. (D) This answer is correct. A contract with the client regarding the amount of time that will be spent discussing the compulsive activities is appropriate. Time allotted should be gradually decreased.
NEW QUESTION # 511
Two hours after the second injection of haloperidol, a client complains to the nurse of a stiff neck and inability to sit still. He is experiencing symptoms consistent with:
- A. Parkinsonism and dystonia
- B. Neuroleptic malignant syndrome
- C. Dystonia and akathisia
- D. Akathisia and parkinsonism
Answer: C
Explanation:
(A) Stiff neck is consistent with a dystonic reaction, but the client has no symptoms of drooling, shuffling gait, or pill-rolling movements characteristic of parkinsonism. (B) Stiff neck is consistent with a dystonic reaction, and inability to sit still with varying degrees of psychomotor agitation is characteristic of akathisia. (C) The client has symptoms of dystonia but not of parkinsonism. (D) The client has none of the characteristic symptoms of neuroleptic malignant syndrome: hyperpyrexia, generalized muscle rigidity, mutism, obtundation, agitation, sweating, increased blood pressure and pulse.
NEW QUESTION # 512
A 48-year-old client presents with a long history of severedepression unrelieved by medication. He is admitted to the hospital for electroconvulsive therapy. Familymembers are very concerned about this therapy and are requesting information about aftereffects of the treatment. The nurse informs the family that he will:
- A. Have transient memory loss, confusion, andheadache
- B. Require no special care after the procedure
- C. Be alert and oriented immediately after the treatment
- D. Have insomnia for the first few days
Answer: A
Explanation:
Explanation
(A) This answer is correct. The client will be confused and have a memory loss, which is usually temporary, after electroconvulsive shock therapy. (B) This answer is incorrect. The client will experience transient memory loss, look bewildered, and be confused initially. (C) This answer is incorrect. The client will sleep immediately following the treatment. (D) This answer is incorrect. Vital signs are taken at least hourly after treatment. The client is monitored for hypotension, tachycardia, respiratory problems, and possible seizure activity.
NEW QUESTION # 513
The nurse notes scattered crackles in both lungs and 1+ pitting edema when assessing a cardiac client.
The physician is notified and orders furosemide (Lasix) 80 mg IV push stat. Which of the following diagnostic studies is monitored to assess for a major complication of this therapy?
- A. 12-Lead ECG
- B. Serum electrolytes
- C. Complete blood count
- D. Arterial blood gases
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Furosemide, a potassium-depleting diuretic, inhibits the reabsorption of sodium and chloride from the loop of Henle and the distal renal tubules. Serum electrolytes are monitored for hypokalemia. (B) Severe acid-base imbalances influence the movement of potassium into and out of the cells, but arterial blood gases to not measure the serum potassium level. (C) Furosemide is a potassium-depleting diuretic. A complete blood count does not reflect potassium levels. (D) Abnormalities in potassium (both hyperkalemia and hypokalemia) are reflected in ECG changes, but these changes do not occur until the abnormality is severe.
NEW QUESTION # 514
A newborn girl's father expresses concern that the newborn does not have good control of her hands and arms. It is important for the father to realize certain neurological patterns that characterize the newborn:
- A. Purposeless, uncoordinated movements of the arms are indicative of neurological dysfunction.
- B. Function progresses in a head-to-toe, proximal-distal fashion.
- C. Asymmetrical movement of the extremities is not unusual and will disappear with maturation of the central nervous system.
- D. Mild hypotonia is expected in the upper extremities.
Answer: B
Explanation:
Explanation/Reference:
Explanation:
(A) Term neonates are predominantly in a flexed position with strong active muscle tone that increases.
Newborns are slightly hypertonic. (B) Neonatal movements may be jerky and uncoordinated as the neonate works against gravity in contrast to the buoyancy of the amniotic fluid. Jerky movements must be differentiated from the tremors of hypoglycemia, hypocalcemia, and neurological dysfunction. (C) Growth of the newborn progresses in a cephalocaudal, proximal-distal fashion. Knowledge regarding infant development may facilitate parental involvement and infant stimulation. (D) Asymmetrical movements of the extremities are indicative of neurological dysfunction.
NEW QUESTION # 515
The nurse and prenatal client discuss the effects of cigarette smoking on pregnancy. It would be correct for the nurse to explain that with cigarette smoking there is increased risk that the baby will have:
- A. Anemia
- B. Nicotine withdrawal
- C. A low birth weight
- D. A birth defect
Answer: C
Explanation:
Explanation/Reference:
Explanation:
(A) Women who smoke during pregnancy are at increased risk for miscarriage, preterm labor, and IUGR in the fetus. (B) Although smoking produces harmful effects on the maternal vascular system and the developing fetus, it has not been directly linked to fetal anomalies. (C) Smoking during pregnancy has not been directly linked to anemia in the fetus. (D) Smoking during pregnancy has not been linked to nicotine withdrawal symptoms in the newborn.
NEW QUESTION # 516
A pregnant client is having a nonstress test (NST). It is noted that the fetal heart beat rises 20 bpm, lasting
20 seconds, every time the fetus moves. The nurse explains that:
- A. The test is normal and the fetus is reacting appropriately
- B. Further testing is needed
- C. The fetus is distressed
- D. The test is inconclusive and should be repeated
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) The test results were normal, so there would be no need to repeat to determine results. (B) There are no data to indicate further tests are needed, because the result of the NST was normal. (C) An NST is reported as reactive if there are two to three increases in the fetal heart rate of 15 bpm, lasting at least 15 seconds during a 15-minute period. (D) The NST results were normal, so there was no fetal distress.
NEW QUESTION # 517
A seventh grader lost consciousness after being hit in the head with a basketball. In the emergency room his vital signs are stable, and he demonstrates no neurologic deficit. He will not be admitted to the hospital. It is most important that you advise his mother to:
- A. Keep him awake for the next 12 hours
- B. Expect him to have nausea with vomiting
- C. Wake him up every 1-2 hours during the night
- D. Encourage him to drink plenty of fluids
Answer: C
Explanation:
(A) Fluid intake should be normal. Fluid intake may be restricted when there is a risk for increased ICP in a hospitalized client. (B) Nausea is possible, but vomiting without nausea is more likely with increased ICP. Neither one should be expected, but the mother should know to notify the physician or hospital if they occur. (C) The child does not need to be kept awake. It is important that he can be aroused from sleep. (D) If the child cannot be awakened from sleep after head injury, it is an indication of serious increase in ICP. The mother should call an ambulance right away.
NEW QUESTION # 518
A client is placed in five-point restraints after exhibiting sudden violence after illegal drug use, and haloperidol (Haldol) 5 mg IM is administered. After 1 hour, his behavior is more subdued, but he tells the nurse, "The devil followed me into this room, I see him standing in the corner with a big knife. When you leave the room, he's going to cut out my heart." The nurse's best response is:
- A. "You'll probably see strange things for a while until the PCP wears off."
- B. "Try to sleep. When you wake up, the devil will be gone."
- C. "You're probably feeling guilty because you used illegal drugs tonight."
- D. "I know you're feeling frightened right now, but I want you to know that I don't see anyone in the corner."
Answer: D
Explanation:
Explanation/Reference:
Explanation:
(A) The nurse is the client's link to reality. This response validates the authenticity of the client's experience by casting doubt on his belief and reinforcing reality. (B) Although this statement may be literally correct, it is nontherapeutic because it lacks validation. (C) This response encourages the client to attempt to do something that may be impossible at this time, offers false reassurance, and reinforces delusional content.
(D) The nurse is making an incorrect assumption about the client's feelings by offering a nontherapeutic interpretation of the motivation for the client's actions.
NEW QUESTION # 519
At her first prenatal visit, a 21-year-old woman who is gravida 2, para 0, ab 1, is currently at 32 weeks' gestation and has a history of drug abuse, smoking, and occasional ethyl alcohol use. Fetal ultrasound tests indicate poor fetal growth. The most likely reason for the infant's intrauterine growth retardation is:
- A. The client's history of drug, ethyl alcohol, and tobacco use
- B. The client's young age
- C. The client's late prenatal care
- D. The client's previous abortion
Answer: A
Explanation:
Explanation/Reference:
Explanation:
(A) Although adolescents frequently have a higher incidence of low-birth-weight infants, this client is 21 years old. (B) Uncomplicated induced abortions have not been proved to influence the growth of infants of subsequent pregnancies. (C) Compounds in cigarettes and some illicit drugs cause maternal vasoconstriction and a subsequent reduction in O2 availability for the fetus owing to the resulting reduction in uteroplacental blood flow. As few as one or two drinks of alcohol per day will decrease birth weight. (D) Although early prenatal care has been shown to improve pregnancy outcomes, not seeking care until the second week of gestation does not, in and of itself, cause intrauterine growth retardation.
NEW QUESTION # 520
The nurse assists a client with advanced emphysema to the bathroom. The client becomes extremely short of breath while returning to bed. The nurse should:
- A. Have him breathe into a paper bag
- B. Encourage pursed-lip breathing
- C. Place him in a lateral Sims' position
- D. Increase his nasal O2 to 6 L/min
Answer: B
Explanation:
Explanation
(A) Giving too high a concentration of O2 to a client with em-physema may remove his stimulus to breathe.
(B) The client should sit forward with his hands on his knees or an overbed table and with shoulders elevated.
(C) Pursed-lip breathing helps the client to blow off CO2 and to keep air passages open. (D) Covering the face of a client extremely short of breath may cause anxiety and further increase dyspnea.
NEW QUESTION # 521
A 67-year-old client will be undergoing a coronary arteriography in the morning. Client
teaching about postprocedure nursing care should include that:
- A. Bed rest with bathroom privileges will be ordered
- B. Some oozing of blood at the arterial puncture site is normal
- C. The leg used for arterial puncture should be kept straight for 8-12 hours
- D. He will be kept NPO for 8-12 hours
Answer: C
Explanation:
(A)
Bed rest will be ordered for 8-12 hours postprocedure. Flexing of the leg at the arterial puncture site will occur if the client gets out of bed, and this is contraindicated after arteriography. (B) The client will be able to eat as soon as he is alert enough to swallow safely and that will depend on what medications areused for sedation during the procedure.
(C)
Oozing at the arterial puncture site is not normal and should be closely evaluated. (D) The leg where the arterial puncture occurred must be kept straight for 8-12 hours to minimize the risk of bleeding.
NEW QUESTION # 522
A successful executive left her job and became a housewife after her marriage to a plastic surgeon. She started doing volunteer work for a charity organization. She developed pain in her legs that advanced to the point of paralysis. Her physicians can find no organic basis for the paralysis. The client's behavior can be described as:
- A. Housework phobia
- B. Malingering
- C. Conversion reaction
- D. Agoraphobia
Answer: C
Explanation:
Explanation
(A) A typical phobia does not result in physical symptoms (i.e., paralysis). (B) Malingering is pretending to be ill. This person has a true paralysis. (C) A conversion reaction is a physical expression of an emotional conflict. It has no organic basis. (D) Agoraphobia is fear of public places.
NEW QUESTION # 523
A client was prescribed a major tranquilizer 2 months ago. One month ago she was placed on benztropine (Cogentin). What would indicate that benztropine therapy is effective?
- A. Tremors
- B. Muscle weakness
- C. Smooth, coordinated voluntary movement
- D. Rigidity
Answer: C
Explanation:
(A) Benztropine is prescribed to decrease or alleviate extrapyramidal side effects of major tranquilizers. Smooth, coordinated voluntary movement indicates minimal extrapyramidal side effects. (B) Tremors are an extrapyramidal side effect. (C) Rigidity is an extrapyramidal side effect. (D) Muscle weakness is an extrapyramidal side effect.
NEW QUESTION # 524
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